Tracheal intubation guide

ABSTRACT

An intubation guide for guiding, positioning and/or insertion of e.g. an endotracheal tube in a patients trachea, and where the intubation guide comprises a relatively flexible guide extending from the distal end of a relatively stiff positioning handle having a curved section between its distal and proximal end, wherein the guide element forms a scoop shaped guide in extension of the positioning handle, and in that the positioning handle comprises an intubation channel extending along the positioning handle, and having a first end near the proximal end of the positioning handle, and the other end at the distal end near the guide scoop.

The present invention relates to a tracheal intubation guide forguiding, positioning and insertion of e.g. an endotracheal tube in apatients trachea, and where the intubation guide comprises a relativelyflexible guide element being attached to the distal end of a relativelystiff, elongated and curved positioning handle, so that it is possible,by manipulating the proximal end of the positioning handle, to insertthe guide scoop in the mouth of a patient, and to push the guide scoopdown the throat of a patient, and place it in a position under thepatients epiglottis and larynx.

DESCRIPTION OF RELATED ART

Intubation guides of the above mentioned type are well known in manydifferent embodiments. A common use for such intubation guides is toprovide a guide for insertion of e.g. an endotracheal tube into thepatient's trachea. In most patients insertion of an endotracheal tubemay be readily performed under direct laryngoscopy of the patients vocalcords using a conventional rigid laryngoscope to create e direct line ofvision for the person performing the intubation procedure. However, itis not always easy and some times impossible to obtain full vision ofthe patient's vocal cords with the result that correct insertion of theendotracheal tube is difficult and unreliable.

U.S. Pat. No. 5,287,848 discloses one example of an intubation guide aneyepiece arranged for visualization of the vocal cords. The structure ofthis intubation guide is made from a one piece, hard plastic, structurebeing difficult to pass gently behind the tongue and underneath the tipof the patient's epiglottis.

U.S. Pat. No. 5,038,766 discloses another example of such an intubationguide mentioned above, where the positioning handle is made of curvedblade member and the guide element is formed as a plug shaped elementmade from a relatively soft material, and having a central channel, sothat the curved blade member can slide the guide element down the throatof the patient until the guide element engages e.g. with the patientsepiglottis and thereby resists further insertion of the guide element,when the correct position of the guide element is reached.

A recurring problem when inserting such intubation guides in a patientis that it is difficult, due to either the size of the guide element orto the hard material used for the guide tip, to insert the intubationguide without the risk of causing trauma to the patient.

SUMMARY OF THE INVENTION

The main object of the present invention is therefore to provide a anintubation guide being easy to insert without risk of trauma to thepatient

This is obtained according to the present invention as defined in claim1, and especially by having the guide element forming a scoop shapedstructure as an extension of the positioning handle, and in that thepositioning handle comprises an intubation channel extending along thepositioning handle, and having a first end near the proximal end of thepositioning handle, and the other end at the distal end near the guidescoop.

Thereby the flexible guide scoop is easier to slide along the palate,below the root of the tongue of the patient, and below the tip of theepiglottis without the risk of causing trauma to the patient, and whenthe guide scoop is placed correctly, then the relatively rigidpositioning handle provides the possibility of easy manipulation of thedistal end of the positioning handle, so that e.g. an endotracheal tubecan be slid into the channel and correctly directed to the patientstrachea.

In a preferred embodiment the intubation channel is open along itsentire length on one side, and at the concave side of the curved sectionof the positioning handle facing the patients tongue and epiglottis whenthe intubation guide is inserted correctly in a patient. Thereby it iseasy to remove the intubation guide after having inserted e.g. theendotracheal tube correctly.

In a preferred embodiment the flexible guide scoop forms an extension ofthe distal end of the positioning handle and extends at least from theconvex side of the intubation channel facing away from the patientsepiglottis when the intubation guide is inserted correctly in a patient,and so that the channel end at the distal end of the positioning handleis placed on one side of the scoop facing the epiglottis when theintubation guide is inserted correctly in a patient.

In this relation the flexible scoop may preferably comprise asubstantially flat and flexible plate or sheet having an outerperiphery, and in that the outer periphery comprises a flexible flange,a flexible inflated or inflatable tube or another flexible meansarranged and adapted for stabilizing the flexible plate or sheet.

Furthermore in a preferred embodiment the flexible scoop or thepositioning handle comprises at least one wedge portion that forms anextension of the distal end of the positioning handle, and where thewedge portion has its wedge point pointing away from the positioninghandle. Thereby it is easy to pass the flexible guide scoop under thepatients epiglottis, as the wedge portion engages the epiglottis andlifts the epiglottis upwardly in the throat of the patient, so that afree view of the vocal cords and an unrestricted passageway for e.g. anendotracheal tube is provided.

The intubation guide according to the invention is very suitable forvideo assisted guiding of e.g. an endotracheal tube. In this relation apreferred embodiment comprises a second channel extending at leastpartly along the positioning handle and having one end being placedclose to the end of the intubation channel placed at the distal end ofthe positioning handle.

In this relation the second channel may preferably form a tube at leastat its end closest to the distal end of the positioning handle, andhaving an optical window arranged for closing the end of the tube at thedistal end of the positioning handle, and where the tube and the opticalwindow be arranged such that it allows an imaging device like anendoscopic video device to be inserted into the tube, and be positionedso that it can provide images of the area on the side of the flexiblescoop facing a patients epiglottis, when the intubation guide iscorrectly inserted in a patient.

The positioning handle may further comprise a third channel extending atleast partly along the positioning handle and having an open end beingplaced close to the end of the intubation channel placed at the distalend of the positioning handle. This facilitates the use of otherinstruments, such as e.g. a surgical instrument without obstruction ofthe other channels.

In a preferred embodiment the positioning handle comprises an extensionfrom the proximal end of the positioning handle, so that easymanipulation of the positioning handle is obtained.

Due to its structural simplicity the intubation guide according to theinvention is especially advantageous as a disposable unit. In thisrelation it is especially advantageous when the handle is made from arelatively hard plastic material, and the scoop is made from arelatively soft plastic material, and where the scoop is attached to thepositioning handle by gluing , welding or moulding.

BRIEF DESCRIPTION OF THE DRAWINGS

In the following, the invention will be described in greater detail withreference to embodiments shown by the enclosed figures. It should beemphasized that the embodiments shown are used for example purposes onlyand should not be used to limit the scope of the invention.

FIG. 1 shows an intubation guide according the invention fitted with anendoscopic video device.

FIG. 2 is an enlarged view of the guide scoop on the intubation guideshown in FIG. 1.

FIG. 3 shows the intubation guide shown in FIG. 1 seen from one side,and with an unflexed guide scoop.

FIG. 4 shows the intubation guide shown in FIG. 1 seen from one side,and with a flexed guide scoop.

FIG. 5 shows a cross section of one embodiment of the intubation guideaccording to the invention seen at along the line A-A on FIG. 3.

FIG. 6 shows an alternative cross section of a second embodiment of theintubation guide according to the invention.

FIG. 7 shows an alternative embodiment of the flexible guide scoop.

DETAILED DESCRIPTION OF THE EMBODIMENTS

FIG. 1 shows one embodiment of an intubation guide 1 according to thepresent invention being equipped with an endoscopic video devicecomprising a display unit 2, and a video camera being placed in theintubation guide 1 and connected to the display unit 2 via the wiring 3.

Although an intubation guide according to the invention is especiallyadvantageous for use with endoscopic video systems it may, however, alsobe used without such a device.

The FIGS. 2 to 5 shows different details of the intubation guideaccording to FIG. 1. The Intubation guide 1 has a guide scoop 4 arrangedon the distal end 5 on the positioning handle 6. This guide scoop is inthis embodiment a flat plate or sheet 7 that is made form a flexiblematerial, and along its periphery it is stabilized by means of aninflated tube 8, so that it forms a flexible scoop shaped structurehaving a size and flexibility that facilitates that the guide scoop canbe inserted into the throat of a patient by flexing the guide scoop sothat it easily slides e.g. along the patients palate 16, below the rootof the tongue and below the tip of epiglottis with a minimum of risk ofcreating trauma to the patient. As an example FIG. 4 shows the guidescoop being flexed against the patient's palate but it is evident thatthe flexible guide scoop is flexible in many other directions, but isable to return to its original shape due to the inflated tube 8.

For the purpose of providing easy manipulation of the intubation guide,then the proximal end 19 of the intubation guide is provided with anextension 20.

On the upper side of the guide scoop 4 is arranged a ramp 9 forming awedge portion 9 extending from the distal end 5 of the positioninghandle 6 and forward in extension of the distal end 5. This wedgeportion 9 has the function of pushing the epiglottis aside when theguide scoop 4 is slid behind or under the patient's epiglottis, so thatan unrestricted passage to the patient's trachea is obtained.

The positioning handle 6 is made of a relatively hard plastic materialand comprises an intubation channel 11 that serves as a conduit forinsertion of e.g. an endotracheal tube (not shown), and thereby it ispossible to use the positioning handle to manipulate the tracheal tubeinto the patients trachea when the intubation guide is correctlyinserted in a patient, by pushing the endotracheal tube in the channelto extend from the distal end 5 of the positioning handle 6, andsteering the endotracheal tube into the trachea of the patient.

The intubation channel 11 is open on one side namely the convex side 12of the curved positioning handle 6, and this convex side will, when theintubation guide rest against the tongue, so that the tongue closes theintubation channel 11 and thereby ensures that the endotracheal tubestays in the intubation channel 11 when it is slid down via the channel11.

After having inserted the endotracheal tube into the patient, then theopen side of the intubation channel 11 allows that the intubation guide1 can be removed from the patient without substantial manipulation ofthe endotracheal tube.

Fur the purpose of avoiding that the tongue closes the channel a flange12 is arranged on each side of the opening in the intubation channel 11.

Next to the intubation channel 11 is arranged a second channel 13 asseen especially on FIG. 5 for the insertion of a endoscopic videocamera, and at the distal end of the positioning handle 6 is arranged awindow for closing the end at the second channel.

As shown in FIG. 6 a third channel may also be provided in analternative embodiment, where this channel may provide the possibilityof inserting other instruments into the patient via the intubationguide.

It will be evident to the skilled person that the present invention maybe realized in other embodiments than the one discloses in FIGS. 1 to 4.As an example of this FIG. 9 shows another embodiment of an intubationguide, where the plate or sheet 7 is stabilized by a flange 18 in steadof the inflated tube 8 according to FIGS. 1 to 4. In this embodiment thewedge 9 shown on the FIGS. 1 to 4 is integrated in the flange 18 on FIG.7.

1. An intubation guide for guiding, positioning and/or insertion of e.g.an endotracheal tube in a patients trachea, and where the intubationguide comprises a relatively flexible guide extending from the distalend of a relatively stiff positioning handle having a curved sectionbetween its distal and proximal ends, characterized in, that the guideelement forms a scoop shaped guide in extension of the positioninghandle, and in that the positioning handle comprises an intubationchannel extending along the positioning handle, and having a first endnear the proximal end of the positioning handle, and the other end atthe distal end near the guide scoop.
 2. An intubation guide according toclaim 1, characterized in, that the intubation channel is open along itsentire length on one side, and at the concave side of the curved sectionof the positioning handle facing the patients tongue and epiglottis whenthe intubation guide is inserted correctly in a patient.
 3. Anintubation guide according to claim 1 or 2, characterized in, that theflexible guide scoop forms an extension of the distal end of thepositioning handle and extends at least from the convex side of theintubation channel facing away from the patients epiglottis when theintubation guide is inserted correctly on a patient, and so that thechannel end at the distal end of the positioning handle is placed on oneside of the scoop facing the epiglottis when the intubation guide isinserted correctly on a patient.
 4. An intubation guide according toclaim 3, characterized in, that the flexible scoop comprises asubstantially flat and flexible plate or sheet having an outerperiphery, and in that the outer periphery comprises a flexible flange,a flexible inflated or inflatable tube or another flexible meansarranged and adapted for stabilizing the flexible plate or sheet.
 5. Anintubation guide according to claim 4, characterized in, that theflexible scoop or the positioning handle comprises at least one wedgeportion that forms an extension of the distal end of the positioninghandle, and where the wedge portion has its wedge point pointing awayfrom the positioning handle.
 6. An intubation guide according to one ormore of the preceding claims claims, characterized in, that thepositioning handle comprises a second channel extending at least partlyalong the positioning handle and having one end being placed close tothe end of the intubation channel placed at the distal end of thepositioning handle.
 7. An intubation guide according to claim 6,characterized hi, that the second channel forms a tube at least at itsend closest to the distal end of the positioning handle, and having anoptical window arranged for closing the end of the tube at the distalend of the positioning handle, and where the tube and the optical windowis arranged such that it allows an imaging device like an endoscopicvideo device to be inserted into the tube, and be positioned so that itcan provide images of the area on the side of the flexible scoop facinga patients epiglottis, when the intubation guide is correctly insertedin a patient.
 8. An intubation guide according to claim 6 or 7,characterized in, that the positioning handle further comprises a thirdchannel extending at least partly along the positioning handle andhaving an open end being placed close to the end of the intubationchannel placed at the distal end of the positioning handle.
 9. Anintubation guide according to one or more of the claims 2 to 8,characterized in, that the positioning handle comprises an extensionfrom the proximal end of the positioning handle for gripping by anoperator.
 10. An intubation guide according to one or more of thepresent claims, characterized in, that the positioning handle is madefrom a relatively hard plastic material, and the scoop is made from arelatively soft plastic material, and where the scoop is attached to thepositioning handle by gluing, welding or molding.